Infection precautions

Infections are a common complication of blood conditions and their treatments, which can result for a number of reasons including lower levels of normally functioning white cells circulating in the blood stream. While infections can occur anywhere in the body; common sites include upper and lower respiratory infections (chest infections), urinary tract infections (kidney infections) and skin infections.

While most are caused by bacteria and viruses; fungal and opportunistic infections (infections caused by microorganisms that are normally harmless in healthy people) are also seen. You may be prescribed preventive (prophylactic) antibiotics especially during and after particular types of treatment. While your white blood cell count is low you should take sensible precautions to help prevent infection. These include washing your hands frequently and using alcohol hand gel.

Tell your friends and family, especially those with small children, that you are at risk of infection and ask them to ring before visiting if they have coughs and colds. Avoid crowds and other close contact with people who may have infections that are contagious (for example colds, flu, chicken pox). Only eat food that has been properly cooked and stored, and avoid sharing food and utensils.

If you do develop an infection you may experience a fever which may or may not be accompanied by an episode of shivering, where you shake uncontrollably. Infections while you are neutropenic can be quite serious and need to be treated with antibiotics as soon as possible. It is important you do not use any drugs to bring your temperature down (i.e. paracetamol) until you are reviewed by your doctor.

This could mask an infection which could lead to serious life threatening complications. Do not take aspirin or ibuprofen in any form as this can increase the risk of bleeding if your platelets are low. Always check with your doctor first. Blood and platelet transfusions If symptoms of anaemia are interfering with your normal daily activities, your doctor may recommend that you have a red blood cell transfusion. Platelet transfusions are sometimes given to prevent or treat bleeding (for example a persistent nose bleed).

You do not need to be admitted to hospital for a red blood cell or platelet transfusion and they are usually given in the outpatient department. Transfusions don’t usually cause any serious complications; nevertheless you will be carefully monitored throughout the transfusion. Alert your nurse if you are feeling hot, cold, and shivery or in any way unwell, as this might indicate that you are having a reaction to the transfusion. Steps can be taken to minimise these effects and ensure that they don’t happen again.

Growth factors

As mentioned earlier, growth factors are natural chemicals in your blood that stimulate the bone marrow to produce different types of blood cells. Some of them can be made in the laboratory and used to help manage your cancer. Erythropoietin (EPO) is an example of a growth factor which is used to stimulate the production of more red blood cells, and can in some cases reduce the need for frequent blood transfusions. Granulocyte-colony stimulating factor (G-CSF) may be given to stimulate the bone marrow to produce more white cells, particularly neutrophils. These white cells help fight bacterial and fungal infections in particular. Growth factors are given as an injection under the skin (subcutaneous). They don’t usually cause any major side effects but some people experience fevers, chills, headaches and some bone pain while using G-CSF. Your doctor may recommend that you take paracetamol to relieve any discomfort you may be feeling.